2017 Buckeye Clay Bash Registration Form

print version

Thursday, February 16 – Sunday, February 19, 2017

Please fill in all blanks and answer all questions. If mailing, please print clearly.

Send an email to Lynda to let her know you have sent your reservation. Lyndag@lyndasartistichaven.com

Make checks payable to: LYNDA GILCHER

Send to: Lynda Gilcher, c/o Lynda's Artistic Haven, 529 Main St., Loveland, Oh 45140. (Ph. # 513-697-9290)

Name: _________________________________________________
Phone #: ________________
Address:_______________________________________________
Email address: ____________________________________
We MUST have the following:
Emergency contact person ___________________________

Emergency contact phone # ____________________________________________________________________________

Roommate Info, check one:

[ ] I need a roommate
[ ] I have roommate(s); name(s) _______________________________
[ ] NO roommate

*If you have special needs (foods, allergies, physical limitations, etc.) please let us know so we can arrange appropriate accommodations.
_________________________________________________________________________________________
EARLY BIRD REGISTRATION-- October 11-November 1, 2016: (Check one of the following)
[ ] Guild Member—4 day $155 [ ] Non-guild member—4 day $170

REGISTRATION FROM NOVEMBER 2-DECEMBER 15, 2016
[ ] Guild Member—4 day $180 [ ] Non-guild member—4 day $195

Cancellation policy:

Cancellation prior to 1/10/17--FULL registration fee
Cancellation 1/11/17 to 1/31/17—registration fee minus $30
Cancellation AFTER 1/31/17—NO REFUND

** Call Hope Hotel for room reservations—937-879-2696. Be sure to ask for the Buckeye Clay Bash room rate ($97.67 per night) when you call.

DAPCG/CPCG/HOPE HOTEL are NOT RESONSIBLE for items which are lost or stolen. Please take care of your property.